Early Intervention for Thumb Sucking Habit: A Case Report

Introduction

Thumb sucking is one of the most prevalent oral habits observed in children. When persistent, it can interfere with normal jaw development, speech articulation, and swallowing patterns. The impact of the habit largely depends on its duration, frequency, intensity, and the child’s facial growth pattern. An open bite at the front is one of the main mouth problems you can get from sucking your thumb too long.

Kids suck their thumbs because it helps them feel okay. Little ones do it a lot, and that's fine. But if older kids keep going, things can start to go wrong. Sucking your thumb all the time can mess with how your teeth and jaw grow, sometimes making your teeth not come together in the front like they should, which is called an open bite. If the thumb sucking stops early, most of the time your teeth and jaw can fix themselves. It can get worse if it continues, and at some point, you might need braces or even a doctor to fix it.

Every kid is different, so there isn't just one right way to help them stop sucking thumbs or fingers. What works best all comes down to the kid. Some children might need ways to change how they act, help from Mom or Dad, or even stuff you put in your mouth to make you want to stop.

In this case, they used a tool called a quad helix with a part that stops your tongue, and it worked to get the child to stop sucking their thumb and fixed the open bite too.

Case Report

Patient History

An 8-year- and 8-month-old girl visited during the mixed dentition stage with a noticeable thumb-sucking habit. On examination, she was found to have a Class II Division I malocclusion, with a 9 mm overjet and a 6 mm anterior open bite. Her upper jaw (maxilla) appeared narrow, and there were small gaps between both the upper and lower central incisors (Figure 1).

Treatment Plan

After discussing the long-term effects of persistent thumb sucking, the patient and her parents were made aware of the importance of their involvement throughout the treatment process. Given the specifics of the case, a fixed quad helix appliance with an integrated tongue crib was selected as the most suitable treatment option This device would act as a reminder to stop the habit while also guiding proper jaw development and bite correction. This appliance functions both as a reminder to discourage thumb sucking and as an orthodontic tool to promote maxillary expansion and spontaneous bite closure.

Treatment Results

Impressively, the child stopped the thumb-sucking habit within just one week of having the appliance fitted. Spontaneous improvement in the anterior open bite was observed soon after, with gradual restoration of functional occlusion.

Discussion

Persistent thumb sucking is a major contributor to the development of anterior open bite, often in combination with other habits, such as pacifier use and tongue thrusting. Early intervention with a habit-breaking appliance is considered effective in mitigating these outcomes.

In this case, a quad helix appliance with a tongue crib served a dual purpose: eliminating the habit and assisting in slow maxillary expansion. This method is widely used in paediatric orthodontics and provides both mechanical and behavioural correction.

As they get older, most children naturally stop thumb sucking, which is a common comfort behaviour in babies and young children. When thumb sucking persists into the mixed dentition stage, a time when baby teeth are being replaced by permanent ones, it can interfere with how the teeth erupt and disrupt the natural development of the bite. A variety of strategies are frequently employed to avoid long-term problems, such as behaviour-based methods, parental support, and occasionally orthodontic appliances made to gently break the habit. Among these, habit-breaking devices are especially helpful, because they not only discourage the habit but also promote healthy tongue posture and avoid interposition when speaking or swallowing.

When a child stops thumb sucking, the teeth often start to shift back into their proper positions on their own. The lower front teeth typically straighten, while the upper front teeth gradually descend, aiding in the closure of the gap referred to as an anterior open bite. Addressing these issues during the mixed dentition phase characterized by the presence of both primary and permanent teeth is especially beneficial, as the jaws are still in development and are more receptive to guidance. Commencing treatment at this point frequently leads to enhanced, more lasting results with a reduced risk of complications.

In many cases like this, breaking the habit early is enough to allow the bite to correct itself naturally, often avoiding the need for more extensive orthodontic treatment.

Conclusion

In this case, using a fixed quad helix appliance with a tongue crib turned out to be an effective way to stop a long-standing thumb-sucking habit and correct an anterior open bite early on. The results show just how important it is to begin treatment at the right time, with active support from both the child and their parents. It also highlights the value of a team-based approach in achieving the best outcomes. By addressing the habit early during the mixed dentition phase, we were able to guide the bite back to normal without needing more complex treatment later on—proving the real benefits of early orthodontic intervention.